What is Guaranteed Issue?

Guaranteed issue rights are rights you have in certain situations when insurance companies must offer you certain Medigap policies. In these situations, an insurance company must:

1. Sell you a Medigap policy
2. Cover all your pre-existing health conditions
3. Can’t charge you more for a Medigap policy regardless of past or present health problems

If you live in Massachusetts, Minnesota, or Wisconsin, you have guaranteed issue rights to buy a Medigap policy, but the Medigap policies are different.

 You have a guaranteed issue right (which means an insurance company can’t refuse to sell you a Medigap policy) in these situations: 

For the Medicare website that explains these situations in more detail, 

CLICK HERE:  https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap/guaranteed-issue-rights# 

You’re in a Medicare Advantage Plan, and your plan is leaving Medicare or stops giving care in your area, or you move out of the plan's service area. 

You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.

You have Original Medicare and a Medicare SELECT policy. You move out of the Medicare SELECT policy's service area. 

You joined a Medicare Advantage Plan or Programs of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare. (Trial Right) 

You dropped a Medigap policy to join a Medicare Advantage Plan (or to switch to a Medicare SELECT policy) for the first time, you’ve been in the plan less than a year, and you want to switch back. (Trial Right) 

Your Medigap insurance company goes bankrupt and you lose your coverage, or your Medigap policy coverage otherwise ends through no fault of your own. 

You leave a Medicare Advantage Plan or drop a Medigap policy because the company hasn't followed the rules, or it misled you. 

Note

There may be times when more than one of the situations above applies to you. When this happens, you can choose the guaranteed issue right that gives you the best choice.

Unsure if YOU have Guaranteed Issue Rights? 

Call us, we would be happy to help you determine your eligibility.